According to a literature source of study performed between june 2012 and june 2015, that evaluated the safety and feasibility of the self-gripping polyester mesh in retromuscular position for the treatment of complex abdominal wall hernia repair.A total of 46 patients were treated in netherlands were included.Among them, 40 patients (87%) were diagnosed with incisional hernia.Seven patients (18%) had incisional hernia combined with another hernia.Four patients (8.7%) had an umbilical hernia, one patient (2.2%) had an epigastric hernia and one patient (2.2%) had rectus diastasis.All hernias were considered as complex.Considering the short-term follow-up (three months): three patients had adverse events during primary hospital admission.One patient had an extended hospital stay of 17 days because of postoperative ileus, which was treated conservatively; one suffered from postoperative angina pectoris, one patient had postoperative pneumonia, and was successfully treated with antibiotics.Ten patients (21.7%) were diagnosed with a postoperative seroma.One was treated with an ultrasound-guided puncture and nine patients were treated conservatively.Five patients showed an adverse event during outpatient follow-up.One patient showed a hematoma which was treated conservatively.Four patients were readmitted to the hospital for various reasons.Two were readmitted for 11 days and 5 days respectively because of administering intravenous antibiotics for the treatment of wound infection.In one patient this infection resulted in a mesh infection, which was treated conservatively.The other two patients were readmitted for diagnostic imaging of late abdominal complaints and ileus, which could not be explained by the surgical intervention.Considering the long-term follow-up, one patient (2.6%) had a mesh infection after 4 months requiring mesh explantation and implantation of a biological mesh.Considering the short-term follow-up (three months): the median follow-up was 15 weeks (inter quartile range; iqr: 7-19 months) in which the median number of outpatient clinic visits was 3 (iqr: 2-4).None (0%) of the 46 patients had a recurrence during this period.At the outpatient clinic 38 patients (82.6%) were without pain.Three patients (6.5%) had mild abdominal pain without use of analgesics; four patients (8.7%) used analgesics daily for moderate abdominal pain.One of the patients (2.2%) suffered from severe pain.Long term follow up (one year or more): thirty-nine patients (85%) were included for long term follow up, median follow up was 25 months (iqr: 19-35 months).Median number of doctors' visits concerning hernia complaints was 0 (iqr 0-2).In total two patients (5.1%) had a recurrence.One of these patients had a pseudobursa and recurrence after 17 months requiring reoperation.The other patient had a recurrence after 19 months requiring reoperation.Thirty patients (77%) reported no pain.Nine patients (23%) reported pain complaints with a mean visual analogue scale (vas) score of 1.7 (range: 1-3).
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